Counties in the Western District: Allegan, Antrim, Barry, Benzie, Berrien, Branch, Calhoun, Cass, Charlevoix, Clare, Clinton, Eaton, Emmet, Grand Traverse, Gratiot, Hillsdale, Ingham, Ionia, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Manistee, Mason, Mecosta, Missaukee, Montcalm, Muskegon, Newaygo, Oceana, Osceola, Ottawa, St. Joseph, Van Buren, Wexford

Western District News


Tricare PTA Services - New Update April 22

posted: April 24, 2020

APTA announced that  the Department of Defense (DoD) released a final rule to add licensed or certified PTAs as TRICARE-authorized providers operating under the same qualifications established by Medicare. Services must be furnished under the supervision of a TRICARE-authorized licensed physical therapist.

This rule says that direct supervision will be required in a private practice setting. General supervision will be required in all settings other than private practice. These guidelines are in line with the Medicare supervision requirements.

The rule is effective on April 16, 2020.

Additional Update April 22:  APTA Advisory: TRICARE Manual Updated to Recognize PTAs as Authorized Providers - April 22, 2020

Don't forget to use the CQ modifier if more than 10% of a service is furnished by a PTA.

TRICARE, the health insurance system used throughout the military, announced that it has officially revised its policy manual to recognize PTAs (and occupational therapy assistants) as authorized providers, outlining the rules and requirements governing assistant qualifications, scope of practice, supervision, and reimbursement.

Now it's up to TRICARE contractors to do the same within approximately 30 days.

As reported earlier, beginning with date of service on April 16, PTAs are recognized as authorized providers under TRICARE and thus eligible for reimbursement for covered services rendered to TRICARE beneficiaries.

Take note: The CQ modifier must be appended to the claim when more than 10% of an outpatient physical therapy service is furnished by the PTA. Check out APTA’s Quick Guide to Using the PTA Modifier.

The presence of the modifier shouldn't impact claims processing. However, if claims are denied, they may need to be resubmitted if the claims are sent to contractors before they fully implement the change.


Special COVID-19 Video Message from MPTA President Mike Shoemaker

posted: March 20, 2020

Please click HERE to view this special message from the MPTA President, Mike Shoemaker.


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